Patient Financial Counselor

It’s inspiring to work with a company where people truly BELIEVE in what they’re doing!

When you become part of the Chapters Health Team, you’ll realize it’s more than a job. It’s a mission. We’re committed to providing outstanding patient care and a high level of customer service in our communities every day. Our employees make all the difference in our success!

Core Responsibilities:

• Patient & Family Financial Counseling
  • Serve as primary financial resource for patients/caregivers prior to admission and/or throughout the episodes-of-care, in collaboration with Admissions/Referral Center.
  • Explain insurance benefits, coverage limitations, patient liability, cost-sharing, and non-covered services in clear, compassionate terms.
  • Provide estimates of patient financial responsibility, including copays, coinsurance, deductibles, and private-pay rates.
  • Assist patients with financial assistance applications, Medicaid spend-down, or alternative payment options when applicable.
• Insurance Verification
  • Verify/Reverify insurance eligibility, benefit levels, and post-acute coverage requirements
  • Understand and track prior authorizations, re-certifications, and continued stay reviews with payers.
  • Identify coverage carve-outs, managed care restrictions, payer-specific documentation needs.

• Admissions & Care Coordination Support
  • Collaborate with Hospice Admissions/Referral Center to include Social Workers and other internal admissions teams to facilitate smooth transitions to post-acute care.
  • Ensure financial clearance prior to admission whenever possible, balancing financial integrity with patient access.
  • Identify coverage risks in collaboration with Insurance Verification Team and escalating issues appropriately.
• Revenue Cycle & Compliance
  • Document insurance verifications, counseling discussions, etc., accurately in the patient account.
  • Ensure compliance with Medicare, Medicaid, and commercial payer regulations related to post-acute services.
  • Identify potential denial risks related to coverage, length of stay, or medical necessity and communicate proactively.
  • Support audits, payer reviews, and appeals by providing accurate financial documentation.
• Performance & Quality Improvement
  • Meet established productivity, accuracy, and timeliness benchmarks.
  • Contribute to denial prevention, reduced avoidable write-offs, and improved point-of-entry financial clearance and/or collections.
  • Participate in ongoing training related to payer rules, hospice reimbursement, and regulatory changes.

Qualifications:

• At least 3 years Patient Financial Counseling or Social Worker experience preferably at a hospital, hospice or other acute care setting.
• Associate’s degree or comparable experience
• Experience establishing health insurance benefits, conditions, and requirements by making phone inquiries, and by using online eligibility systems.
• Ability to communicate compassionately and professionally with patients and families.
• Knowledge of medical insurance and government payers and reimbursement
• Excellent customer service skills and experience.
• Proficiency in Microsoft Office applications, especially Excel.
• Familiarity with healthcare regulations.

Compensation Pay Range:

This position requires consent to drug and/or alcohol testing after a conditional offer of employment is made, as well as on-going compliance with the Drug-Free Workplace Policy.

All Chapters Health System employees performing services for Florida affiliates are submitted through the Florida Care Provider Background Screening Clearinghouse to verify eligibility after a conditional offer of employment is made as well as ongoing eligibility. For more information, please visit https://info.flclearinghouse.com/.